The Civil Rights Era 1955-1968

Medicine and the Civil Rights Movement

Medicine played a major role in civil rights movement, but largely outside of AMA Physicians organized and participated in civil rights marches Physicians played a role in picket lines and patient advocacy Physicians filed lawsuits that sought to end hospital segregation JNMA published Integration William Montague Cobb (1904-1990). Battlefront Editor of JNMA (1949-1977) and
President of the NMA (1964-1965).

Hospitals and Professional Advancement

The importance of hospital staff integration, and relationship to integration in organized medicine
Board certification important for pursuing medical specialties and honing skills Specialty training took place in hospitals Hospitals often required their staff to be members of a medical society and/or AMA Thus, racial bars to society membership were barriers to specialty training and professional advancement

Source: IR Clark Collection (right) http://www.oldnorthstatemedicalsociety.org/virtualMuseum/Main%20-%20ONSMS%20Virtual%20Museum.html http://www.american.edu/bgriff/H207web/civrights/coloredwaitingroom.jpg (left)

In 1931, out of 25,000 specialists in US, 2 were African American

&
William Harry Barnes (American Board of Otolaryngology, 1927)

Daniel Hale Williams (American College of Surgeons, 1913)

Source: http://www.africanamericans.com/images2/DanielHaleWilliams.jpg

Legal Remedies to Hospital Desegregation

Eaton v. James Walker Memorial Hospital
(1961) Court finds that Hubert A. Eaton and other African Americans were wrongfully denied staff privileges. Eaton won his appeal after a decade of litigation.

Simkins v. Moses H. Cone Memorial Hospital

(1963) Fourth Circuit Court of Appeals finds it unconstitutional to discriminate against black physicians in hospitals built with federal funds under the Hill-Burton program.
Hubert A. Eaton (1916-1991)

AMA Reaffirms Jim Crow Segregation

1939 AMA appointed committee to consider problems inimical to the welfare of colored physicians AMA decried racial discrimination in state/local society membership AMA noted that a large number of colored physicians were AMA members But every medical society has the right of self governance inmembership

Peter Marshall Murray of NY (1888-1969). First African American elected to the AMA House House of Delegates (1950-1961).

AMA Policies on Discrimination in State and Local Societies

1940-1964, many attempts to change discriminatory membership policies were rebuffed

Policy Proposal 1944 NMA members requested associate membership in AMA 1952 Old North State Medical Society requested to be a constituent association of AMA 1963 Exclude societies with discriminatory membership policies

AMA Action Denied Denied

Denied

Reasons given for AMA Inaction

Progress is being made in integrating Southern societies The AMA has many Negro members Many Negro members of state medical societieshave not chosen to become members of the [AMA] Membership in state/local societies is outside the jurisdiction of the [AMA]

Martha Mendell Physicians Forum

In 1952: The continued exclusion of Negro physicians by southern medical societies is not just a national, but an international disgrace. The claim of the AMA that it is powerless to correct this practice because of the autonomy of its component societies is an evasion of its responsibility. Surely, if the southern medical societies decided to admit chiropractors to membership the AMA would quickly find the means of re-defining this autonomy.

Dr. Arthur H. Coleman JNMA Legal Correspondent

In 1964 says the AMA is acting like:
[a] man who is standing on the shoreline watching a fellow-man floundering in the sea and proclaiming to the world and to his God that he does not believe in drowning. This alone does nothing for the man in the sea.Their conscience may be eased so that they can sleep at night to take a stand against discrimination, but, it takes a concerted effort of positive action to rescue those caught in the sea of discrimination.

Arthur H. Coleman (1920-)

Civil Rights Not a Priority for AMA

Civil rights are almost completely unmentioned in AMA records AMA ignores or even obstructs civil rights agenda
Elects not to defend African American physicians arrested in Atlanta for attending the Fulton County Medical Associations whitesonly luncheon Opposes Oath of Compliance to Title VI of the Civil Rights Act JAMA declines to publish letter about Selma march because it is controversial Repeatedly declines to support NMA on HillBurton changes

Anthony J. Celebrezze
HEW Secretary (1962-1965)

Source: US Social Security Administration http://www.ssa.gov/history/pics/celebrez.jpg

Picketing the AMA

NMA found AMA inaction to be totally inadequate NMA, Medical Committee for Human Rights, and others picketed AMA meetings in 1963, 1965, 1966, and 1968 AMA responded in 1963:
[The Picketing serves only] to obscure the achievements in medical science being reported at the meeting
Photos- Members of the NMA, MCHR, and others picket AMA meetings in 1965 (above) and 1966 (below). John L. S. Holloman, Jr. (1919-2002) (above left)

Imhotep Conferences on Hospital Integration

1957 First conference organized by JNMA editor, W. Montague Cobb, NMA, NAACP, et al. AMA was invited and sent representatives At future Imhotep meetings, AMA refused to participate fully and actively

After Repeated AMA Absenteeism

In 1963, NMA President Cobb stated in part:
for seven years we have invited [AMA representatives] to sit down with us and solve the problem [of hospital integration]. The high professional and economic levels of these bodies and the altruistic religious principles according to which they are supposed to operate seem to have meant nothingBy their refusal to confer they force action by crisis. And now events have passed beyond them. The initiative offered is no longer theirs to accept.

The initiative was, indeed, no longer the AMAs to accept

President Johnson Signing Civil Rights Act of 1964 Martin Luther King, Jr. (behind) http://www.american.edu/bgriff/H207web/civrights/LBJcivrights1964.jpg

The AMA Judicial Council

After desegregation became the law of the land, the AMA voted to amend the Constitution and Bylaws, giving the Judicial Council the authority to
(1966) Investigate allegations of discrimination in state/local societies (1968) Expel state/local societies found guilty of racial discrimination

A number of key events since 1968

1968 AMA first expressed need to increase number of African American physicians 1989 First AMA report on Black-White Disparities in Health Care 1992 AMAs Minority Affairs Consortium created 1994 Lonnie Bristow becomes first African American AMA President 2004 Commission to End Health Care Disparities created, with NMA and NHMA
Doctors Back to School Minority Scholar Awards Cultural Competence work, etc

Powerful Effects of this Legacy

African Americans make up
12.3% of the US population (2006) 2.2% of physicians and medical students (2006)
As compared to 2.5% in 1910, at the time of the Flexner Report

1.8% of AMA members (2006)

What are the effects of this lack of diversity?

What happens when a group is under-represented in a democratic organization?

Ongoing segregation, and mistrust of medicine, are key drivers of disparities

Summary In the US, organized medicine emerged from a society deeply divided over slavery, but largely accepting of racial inequities and theories espousing black inferiority. Emblematic of existing societal values and practices, medical schools, residency programs, hospital staffs and professional societies largely excluded African Americans. For more than 100 years, many medical associations, including the AMA, actively reinforced or passively accepted this exclusion. Throughout this history, vocal groups of physiciansblack and white, and within and outside these associations challenged segregation and racism. This history is still being written

http://www.ama-assn.org/go/AfAmHistory

Project website http://www.ama-assn.org/go/AfAmHistory